Bradshaw B S, Smith D P
University of Texas School of Public Health, Health Science Center at San Antonio 78284, USA.
Soc Biol. 1997 Spring-Summer;44(1-2):25-41.
Through a series of life table analyses, this paper describes the natural history of tuberculosis mortality in a Mexican-origin community over five decades (1935-84) during which the disease underwent a transition from a major underlying cause of death to a disease conditioned mentioned more often on death certificates as contributing to death than causing death. The decline in death rates from 1940 to 1950 was especially remarkable. Successive birth cohorts of Mexican Americans, separated by as little as five years of age, experienced distinctly lower risk of death from tuberculosis as they entered young adulthood. There was a rapid convergence in age-specific patterns of tuberculosis death rates in Mexican Americans toward those of non-Hispanic whites, so that by 1960 tuberculosis was primarily a cause of death in old age rather than young adulthood. The impact of changing environment, both through improvements of conditions within neighborhoods and through residential mobility, on birth cohorts at risk of tuberculosis needs to be examined in further research.
通过一系列生命表分析，本文描述了一个墨西哥裔社区在五十年间（1935 - 1984年）结核病死亡率的自然史，在此期间，该疾病经历了从主要潜在死因到在死亡证明上更多作为导致死亡的促成因素而非死因被提及的疾病的转变。1940年至1950年死亡率的下降尤为显著。仅相差五岁的连续出生队列的墨西哥裔美国人在进入青年期时，患结核病死亡的风险明显较低。墨西哥裔美国人结核病死亡率的年龄特异性模式迅速向非西班牙裔白人的模式趋同，以至于到1960年，结核病主要成为老年人而非青年期的死因。在进一步的研究中，需要考察不断变化的环境（包括邻里环境的改善和居住流动性）对有结核病风险的出生队列的影响。
